Individual
DEBORAH L LALICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
6661 CLYO RD, CENTERVILLE, OH 45459-2767
(937) 425-4000
(937) 425-4002
Mailing address
6661 CLYO RD, CENTERVILLE, OH 45459-2767
(937) 425-4000
(937) 425-4002
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
08684
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2825723
—
OH
Enumeration date
08/24/2006
Last updated
01/19/2021
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